Irina Dijmărescu, Adrian Dumitru Dijmărescu, Mirela Luminița Pavelescu, Cristina Adriana Becheanu
ABSTRACT
Introduction: Pulmonary aspergillosis is a severe rare disease, which often occurs in immunosuppressed patients. Case report: The authors present the case of a 17-year-old adolescent with autoimmune liver cirrhosis (onset 18 months prior), splenectomy and immunosuppressive therapy. He developed pulmonary and cerebral invasive aspergillosis. The patient was receiving complex immunosuppressive therapy and developed rapid progressive bilateral pneumonia under antibiotherapy, with numerous lung abscesses, extensive necrosis and pyopneumothorax. Aspergillus fumigatus was identified in the tracheobronchial aspirate. Three weeks after, right motor deficit and right facial palsy were seen. The CT showed multiple cerebral and cerebellar abscesses secondary to aspergillus. Cerebral and pulmonary lesions improved with antifungal therapy (Voriconazole), but the liver disease worsened rapidly. The patient died due to esophageal varices rupture. Conclusions: Invasive aspergillosis is a severe opportunistic infection with fulminant evolution in immunosuppressed patients. Diagnosis and treatment represent a challenge in these conditions.
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